• 제목/요약/키워드: mixed outcomes

검색결과 142건 처리시간 0.026초

Facial Soft Tissue Augmentation using Autologous Fat Mixed with Stromal Vascular Fraction

  • Lee, Sang Kyun;Kim, Deok-Woo;Dhong, Eun-Sang;Park, Seung-Ha;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • 제39권5호
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    • pp.534-539
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    • 2012
  • Background Autologous fat grafting evolved over the twentieth century to become a quick, safe, and reliable method for restoring volume. However, autologous fat grafts have some problems including uncertain viability of the grafted fat and a low rate of graft survival. To overcome the problems associated with autologous fat grafts, we used uncultured adipose tissue-derived stromal cell (stromal vascular fraction, SVF) assisted autologous fat grafting. Thus, the purpose of this study was to evaluate the effect of SVF in a clinical trial. Methods SVF cells were freshly isolated from half of the aspirated fat and were used in combination with the other half of the aspirated fat during the procedure. Between March 2007 and February 2008, a total of 9 SVF-assisted fat grafts were performed in 9 patients. The patients were followed for 12 weeks after treatment. Data collected at each follow-up visit included clinical examination of the graft site(s), photographs for historical comparison, and information from a patient questionnaire that measured the outcomes from the patient perspective. The photographs were evaluated by medical professionals. Results Scores of the left facial area grafted with adipose tissue mixed with SVF cells were significantly higher compared with those of the right facial area grafted with adipose tissue without SVF cells. There was no significant adverse effect. Conclusions The subjective patient satisfaction survey and surgeon survey showed that SVF-assisted fat grafting was a surgical procedure with superior results.

한국복지패널 자료를 이용한 아동기 공격성에 대한 경시적 자료 분석 (A longitudinal study for child aggression with Korea Welfare Panel Study data)

  • 최나연;허집
    • Journal of the Korean Data and Information Science Society
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    • 제25권6호
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    • pp.1439-1447
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    • 2014
  • 한국 학생들의 아동기 혹은 청소년기의 공격성에 대한 연구들은 대부분 횡단자료를 이용한 것들이다. 경시적 자료를 이용한 연구가 있지만, 반복측정된 자료들이 서로 독립이라는 가정 하에 연구되었다. 본 연구에서는 2006년부터 2012년까지 세 차례 반복측정에 의해 얻어진 한국복지패널 자료를 이용하여, 횡단자료 분석 연구의 결과인 아동 혹은 청소년의 공격성에 영향을 미치는 요인들로 알려진 학교 적응, 자아존중감, 우울 및 불안, 비행, 학교 폭력 피해 경험, 부모로부터 학대 경험과 인터넷 사용시간이 경시적 자료 분석에서도 공격성에 영향을 주는 지를 분석하고자 한다. 한국복지패널 자료의 결측치는 임의결측을 가정하고, 제한적 최우추정량을 이용한 선형혼합모형을 적합하고자 한다.

Clinical efficacy of chloroquine versus artemether-lumefantrine for Plasmodium vivax treatment in Thailand

  • Krudsood, Srivicha;Tangpukdee, Noppadon;Muangnoicharoen, Sant;Thangchartwet, Vipa;Luplertlop, Nutthanej;Srivilarit, Siripan;Wilairatana, Polrat;Kano, Shigeyuki;Ringwald, Pascal;Looareesuwan, Sornchai
    • Parasites, Hosts and Diseases
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    • 제45권2호
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    • pp.111-114
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    • 2007
  • Chloroquine remains the drug of choice for the treatment of vivax malaria in Thailand. Mixed infections of falciparum and vivax malaria are also common in South-East Asia. Laboratory confirmation of malaria species is not generally available. This study aimed to find alternative regimens for treating both malaria species by using falciparum antimalarial drugs. From June 2004 to May 2005, 98 patients with Plasmodium vivax were randomly treated with either artemether-lumefantrine (n = 47) or chloroquine (n = 51). Both treatments were followed by 15 mg of primaquine over 14 days. Adverse events and clinical and parasitological outcomes were recorded and revealed similar in both groups. The cure rate was 97.4% for the artemether-lumefantrine treated group and 100% for the chloroquine treated group. We concluded that the combination of artemether-lumefantrine and primaquine was well tolerated, as effective as chloroquine and primaquine, and can be an alternative regimen for treatment of vivax malaria especially in the event that a mixed infection of falciparum and vivax malaria could not be ruled out.

Plate waste study among hospitalised patients receiving texture-modified diet

  • Razalli, Nurul Huda;Cheah, Chui Fen;Mohammad, Nur Mahirah Amani;Manaf, Zahara Abdul
    • Nutrition Research and Practice
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    • 제15권5호
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    • pp.655-671
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    • 2021
  • BACKGROUND/OBJECTIVES: While plate waste has been widely investigated in hospitals, there have been minimal studies specific to the texture-modified diet (TMD). This study aims to determine the percentage of plate waste among patients prescribed with TMD and its contributory factors. SUBJECTS/METHODS: This was a single-centre study conducted in the university hospital on three types of TMD (blended diet, mixed porridge, minced diet) during lunch and dinner meals. Weighing method and visual estimation method assisted by digital photograph were adopted in this study. Face to face interview was carried out to investigate on 1) the food/food service quality factors in terms of patients' satisfaction level towards sensorial quality of food and food services provided and 2) the clinical/external factors including appetite, the provision of oral nutrition support, time taking the diet, the need for feeding assistance and the length of hospital stay. RESULTS: The mean percentage of overall plate waste of 95 patients receiving TMD was high (47.5%). Blended diet was identified as the most wasted diet (65%) followed by minced diet (56%) and mixed porridge (35%). Satisfaction level among patients was moderate. Patients on TMD in general had higher satisfaction level on the aspect of food service as compared to food quality. Substantial association between sensorial qualities of food and plate waste were varied according to individual TMD type. A multiple linear regression showed that only the satisfaction level toward the aspects of appearance and variety of foods were the predictors of TMD plate waste (R2 = 0.254, P < 0.05). CONCLUSIONS: A significant relationship between the percentage of plate waste and the overall satisfaction level of patients receiving TMD suggests that vigorous strategies are needed to reduce the food waste of TMD which will lead to a better nutritional status and clinical outcomes among the patients.

제2형 당뇨병 환자를 위한 자동 맞춤형 셀프케어 프로그램 개발 (The Development of Automated Personalized Self-Care (APSC) Program for Patients with Type 2 Diabetes Mellitus)

  • 박가은;이해정;강아름
    • 대한간호학회지
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    • 제52권5호
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    • pp.535-549
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    • 2022
  • Purpose: The study aimed to design and develop an automated personalized self-care (APSC) program for patients with type 2 diabetes mellitus. The secondary aim was to present a clinical protocol as a mixed-method research to test the program effects. Methods: The APSC program was developed in the order of analysis, design, implementation, and evaluation according to the software development life cycle, and was guided by the self-regulatory theory. The content validity, heuristics, and usability of the program were verified by experts and patients with type 2 diabetes mellitus. Results: The APSC program was developed based on goal setting, education, monitoring, and feedback components corresponding to the phases of forethought, performance/volitional control, and self-reflection of self-regulatory theory. Using the mobile application, the participants are able to learn from educational materials, monitor their health behaviors, receive weekly-automated personalized goals and feedback messages, and use an automated conversation system to solve the problems related to self-care. The ongoing two-year study utilizes a mixed method design, with 180 patients having type 2 diabetes mellitus randomized to receive either the intervention or usual care. The participants will be reviewed for self-care self-efficacy, health behaviors, and health outcomes at 6, 12, 18, and 24 months. Participants in the intervention group will be interviewed about their experiences. Conclusion: The APSC program can serve as an effective tool for facilitating diabetes health behaviors by improving patients' self-care self-efficacy and self-regulation for self-care. However, the clinical effectiveness of this program requires further investigation.

Mixed reality visualization in shoulder arthroplasty: is it better than traditional preoperative planning software?

  • Sejla Abdic;Nicholas J. Van Osch;Daniel G. Langohr;James A. Johnson;George S. Athwal
    • Clinics in Shoulder and Elbow
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    • 제26권2호
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    • pp.117-125
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    • 2023
  • Background: Preoperative traditional software planning (TSP) is a method used to assist surgeons with implant selection and glenoid guide-pin insertion in shoulder arthroplasty. Mixed reality (MR) is a new technology that uses digital holograms of the preoperative plan and guide-pin trajectory projected into the operative field. The purpose of this study was to compare TSP to MR in a simulated surgical environment involving insertion of guide-pins into models of severely deformed glenoids. Methods: Eight surgeons inserted guide-pins into eight randomized three-dimensional-printed severely eroded glenoid models in a simulated surgical environment using either TSP or MR. In total, 128 glenoid models were used and statistically compared. The outcomes compared between techniques included procedural time, difference in guide-pin start point, difference in version and inclination, and surgeon confidence via a confidence rating scale. Results: When comparing traditional preoperative software planning to MR visualization as techniques to assist surgeons in glenoid guide pin insertion, there were no statistically significant differences in terms of mean procedure time (P=0.634), glenoid start-point (TSP=2.2±0.2 mm, MR=2.1±0.1 mm; P=0.760), guide-pin orientation (P=0.586), or confidence rating score (P=0.850). Conclusions: The results demonstrate that there were no significant differences between traditional preoperative software planning and MR visualization for guide-pin placement into models of eroded glenoids. A perceived benefit of MR is the real-time intraoperative visibility of the surgical plan and the patient's anatomy; however, this did not translate into decreased procedural time or improved guide-pin position.

Incorporation of amoxicillin-loaded microspheres in mineral trioxide aggregate cement: an in vitro study

  • Fabio Rocha Bohns;Vicente Castelo Branco Leitune;Isadora Martini Garcia;Bruna Genari;Nelio Bairros Dornelles Junior;Silvia Staniscuaski Guterres;Fabricio Aulo Ogliari;Mary Anne Sampaio de Melo;Fabricio Mezzomo Collares
    • Restorative Dentistry and Endodontics
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    • 제45권4호
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    • pp.50.1-50.11
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    • 2020
  • Objectives: In this study, we investigated the potential of amoxicillin-loaded polymeric microspheres to be delivered to tooth root infection sites via a bioactive reparative cement. Materials and Methods: Amoxicillin-loaded microspheres were synthesized by a spray-dray method and incorporated at 2.5% and 5% into a mineral trioxide aggregate cement clinically used to induce a mineralized barrier at the root tip of young permanent teeth with incomplete root development and necrotic pulp. The formulations were modified in liquid:powder ratios and in composition by the microspheres. The optimized formulations were evaluated in vitro for physical and mechanical eligibility. The morphology of microspheres was observed under scanning electron microscopy. Results: The optimized cement formulation containing microspheres at 5% exhibited a delayed-release response and maintained its fundamental functional properties. When mixed with amoxicillin-loaded microspheres, the setting times of both test materials significantly increased. The diametral tensile strength of cement containing microspheres at 5% was similar to control. However, phytic acid had no effect on this outcome (p > 0.05). When mixed with modified liquid:powder ratio, the setting time was significantly longer than that original liquid:powder ratio (p < 0.05). Conclusions: Lack of optimal concentrations of antibiotics at anatomical sites of the dental tissues is a hallmark of recurrent endodontic infections. Therefore, targeting the controlled release of broad-spectrum antibiotics may improve the therapeutic outcomes of current treatments. Overall, these results indicate that the carry of amoxicillin by microspheres could provide an alternative strategy for the local delivery of antibiotics for the management of tooth infections.

Treating Adults with Hodgkin Lymphoma in the Developing World: a Hospital-Based Cohort Study from Armenia

  • Avagyan, Armen;Danielyan, Samvel;Voskanyan, Astghik;Sargsyan, Lilit;Hakobyan, Lusine;Zohrabyan, Davit;Safaryan, Liana;Harutyunyan, Lilit;Bardakchyan, Samvel;Iskanyan, Samvel;Arakelyan, Samvel;Tamamyan, Gevorg
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권1호
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    • pp.101-104
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    • 2016
  • Background: With advances in diagnostics and treatment approaches, patients with Hodgkin's lymphoma (HL) in developed countries can nowadays expect to have excellent outcomes. However, information about the characteristics and outcomes in the developing world is very scarce, and this is important given the fact that there are several reports about differences of disease characteristics depending on geographic location and the development level of the country. Materials and Methods: In this retrospective study we assessed the features of 36 adult (${\geq}18$ years old) patients with HL and their diagnosis and treatment and outcomes in the Clinic of Chemotherapy of Muratsan University Hospital of Yerevan State Medical University, Armenia, between 2008-2014. Results: All patients had classic HL and among them 19 (53%) had nodular sclerosis subtype, 8 (22%) mixed cellularity and 9 (25%) lymphocyte-rich. 16 (44.5%) patients were at stage II, 13 (36%) stage III and 7 (19.5%) stage IV. Median follow-up time was 24.5 months (range 1-71 months) and during the whole follow-up period only two relapses (early) were documented and there were no deaths. Twenty-three (64%) patients received a BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) regimen, and 13 (36%) ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) regimen. A total of 25 (69.5%) patients received radiation in addition to chemotherapy. Conclusions: Although the number of patients involved in the study is small and the median follow-up time was just two years, this retrospective study shows that treatment of HL can be successfully organized in a resource-limited setting.

Value of Additional Instrumented Fusion in the Treatment of Thoracic Ossification of the Ligamentum Flavum

  • Hwang, Sung Hwan;Chung, Chun Kee;Kim, Chi Heon;Yang, Seung Heon;Choi, Yunhee;Yoon, Joonho
    • Journal of Korean Neurosurgical Society
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    • 제65권5호
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    • pp.719-729
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    • 2022
  • Objective : The ossification of the ligamentum flavum (OLF) is one of the major causes of thoracic myelopathy. Surgical decompression with or without instrumented fusion is the mainstay of treatment. However, few studies have reported on the added effect of instrumented fusion. The objective of this study was to compare clinical and radiological outcomes between surgical decompression without instrumented fusion (D-group) and that with instrumented fusion (F-group). Methods : A retrospective review was performed on 28 patients (D-group, n=17; F-group, n=11) with thoracic myelopathy due to OLF. The clinical parameters compared included scores of the Japanese Orthopedic Association (JOA), the Visual analogue scale of the back and leg (VAS-B and VAS-L), and the Korean version of the Oswestry disability index (K-ODI). Radiological parameters included the sagittal vertical axis (SVA), the pelvic tilt (PT), the sacral slope (SS), the thoracic kyphosis angle (TKA), the segmental kyphosis angle (SKA) at the operated level, and the lumbar lordosis angle (LLA; a negative value implying lordosis). These parameters were measured preoperatively, 1 year postoperatively, and 2 years postoperatively, and were compared with a linear mixed model. Results : After surgery, all clinical parameters were significantly improved in both groups, while VAS-L was more improved in the F-group than in the D-group (-3.4±2.5 vs. -1.3±2.2, p=0.008). Radiological outcomes were significantly different in terms of changes in TKA, SKA, and LLA. Changes in TKA, SKA, and LLA were 2.3°±4.7°, -0.1°±1.4°, and -1.3°±5.6° in the F-group, which were significantly lower than 6.8°±6.1°, 3.0°±2.8°, and 2.2°±5.3° in the D-group, respectively (p=0.013, p<0.0001, and p=0.037). Symptomatic recurrence of OLF occurred in one patient of the D-group at postoperative 24 months. Conclusion : Clinical improvement was achieved after decompression surgery for OLF regardless of whether instrumented fusion was added. However, adding instrumented fusion resulted in better outcomes in terms of lessening the progression of local and regional kyphosis and improving leg pain. Decompression with instrumented fusion may be a better surgical option for thoracic OLF.

Early Detection and Gemcitabine/Cisplatin Combination Positively Effect Survival in Sarcomatoid Carcinoma of the Urinary Bladder

  • Baseskioglu, Barbaros;Duman, Berna Bozkurt;Kara, I. Oguz;Can, Cavit;Yildirim, Mustafa;Acikalin, Mustafa
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권11호
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    • pp.5729-5733
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    • 2012
  • Background and Objectives: This study aimed to present the clinicopathological characteristics and treatment of patients with bladder carcinoma with sarcomatoid differentiation at our institution. Methods: Between 1995-2009, 950 patients were followed-up for bladder carcinoma. Among them, 14 patients with sarcomatoid carcinoma were retrospectively reviewed, and their clinical, pathological features and treatment were recorded. Results: Median age of the patients was 65 years (range: 41-86 years), 12 (86%) being male and 2 (14%) female. All the patients presented with hematuria and 11 (88%) had a history of smoking. The tumor growth pattern was solid in 10 patients, papillary in 2, and mixed in 2. In all, 5 of the patients had urothelial carcinoma with sarcomatoid differentiation and 9 were diagnosed with sarcomatoid carcinoma. Five patients underwent radical cystectomy with ileal conduit surgery, 2 patients refused cystectomy, and 8 patients underwent re-TUR. Following diagnosis, 12 of the patients died in mean 10.7 months (range: 1-48 months). Conclusion: Urothelial carcinomas with sarcomatoid features are aggressive and are usually at advanced stage at the time of diagnosis. The outcomes of multimodal treatment are not satisfactory. Significant findings of the present study are that early diagnosis positively affect survival and that gemcitabine and cisplatin in combination can positively affect survival.